Wet Macular Degeneration Prognosis: Outlook and More (2024)

Wet age-related macular degeneration (AMD) causes rapid and progressive central vision loss. Early treatment can reduce the amount of vision loss you experience.

Your retina is the surface at the back of each eye that captures images and sends them along the optic nerve to your brain. At the center of each retina is an area called the macula. Your macula processes your central vision and helps you focus on tasks like driving, seeing fine detail, and reading this article.

If you have macular degeneration, the cells in your macula are degrading. This can affect your vision.

At first, you may not be aware of any vision loss, but your eye doctor can see changes to your retina. As macular degeneration progresses, you will begin to notice vision loss.

A combination of environmental and genetic factors causes macular degeneration. It’s usually referred to as age-related macular degeneration (AMD) in people over 55 years old.

According to the American Macular Degeneration Foundation, about 85% to 90% of AMD diagnoses are dry (atrophic) AMD. Atrophic refers to the macula’s decrease in size. The remaining 10% to 15% are wet (exudative) AMD. Exudative means leaking fluid.

With dry AMD, the photoreceptor and retinal pigmented epithelial (RPE) cells in the macula deteriorate and die. This can progress to wet AMD when cell death causes an abnormal growth of blood vessels in the area. When these vessels leak and bleed, they damage your central vision.

Both wet and dry AMD cause deterioration in central vision, but this change happens faster with wet AMD. Wet AMD can affect your vision rapidly within a few weeks, unlike dry AMD, which can take years before it causes vision loss.

Symptoms

With wet AMD, you might have a blank or blurry area in the middle of your field of vision. You may also experience visual distortions, like straight lines or surfaces appearing to be bent or wavy.

Low light may cause visual challenges, and you may not be able to recognize faces as easily as you have in the past.

You might even experience a visual hallucination called Charles Bonnet syndrome. This happens when your brain tries to compensate for your vision interruption by inserting images that aren’t real, such as flowers or animals.

This type of hallucination is part of vision loss and doesn’t indicate reduced mental capacity.

Wet AMD has no cure, but prompt treatment can slow its progression and help relieve symptoms. Controlling the bleeding from your blood vessels is a big aspect of treatments.

Lifestyle changes

Lifestyle changes can help protect your vision but cannot slow wet AMD.

Lifestyle changes for wet AMD can include:

  • exercising regularly
  • maintaining a healthy weight for your body size
  • eating nutritious food like dark, leafy greens
  • managing your blood pressure and cholesterol
  • not smoking, or trying a smoking cessation program
  • protecting your eyes from sunlight with hats and sunglasses that offer 100% UV protection

Vitamins can help prevent dry AMD from becoming wet AMD. Two large studies, the Age-Related Eye Disease Studies (AREDS/AREDS2), revealed that nutrients can slow the progression of early and mid-stage dry AMD so that it doesn’t become wet AMD. These nutrients include:

  • vitamin C
  • vitamin D
  • copper
  • zinc

For example, in the AREDS study, researchers found that people at high risk of developing advanced AMD reduced their progression risk by about 25% when treated with the combination of:

  • antioxidants
  • zinc
  • copper

However, there was no benefit for people with early AMD or those without AMD.

Prescription medications

Anti-vascular endothelial growth factor (anti-VEGF) injections into the eye can reduce abnormal blood vessel formation. These injections are usually given every 4 to 8 weeks.

Most people treated with anti-VEGF medication keep their eyesight and may even regain some of the vision that was previously lost. Approved medications are:

  • Avastin
  • Beovu (brolucizumab)
  • Eylea (aflibercept)
  • Lucentis (ranibizumab)
  • Susvimo (ranibizumab injection for intravitreal use via ocular implant)
  • Vabysmo (faricimab-svoa)

Surgical options

Laser treatments, called photodynamic therapy, can reduce the number of abnormal blood vessels in the eye and help minimize the amount they leak.

An intraocular lens (IOL) can also be surgically implanted into the eye to redirect incoming images to an undamaged area of the retina. Several types of IOLs can be used, including an implantable miniature telescope (IMT).

Slowing progression from dry to wet AMD

If you have dry AMD, ask your doctor how to self-monitor for signs that your condition is progressing to wet AMD. If identified early, treatment can reduce vision damage.

Your doctor may recommend that you perform a daily vision check using an Amsler grid. This grid helps you check for vision changes that indicate you may benefit from treatment.

Without treatment, wet AMD causes rapid, progressive central vision loss. Although wet AMD accounts for only about 10% of macular degeneration diagnoses, it accounts for around 90% of the significant vision loss from this condition, reports the BrightFocus Foundation, a nonprofit research organization.

If you’ve already experienced some vision loss, occupational therapy can help you learn strategies to live with reduced vision. A therapist can teach you how to modify your environment and make use of your peripheral vision in your daily activities.

You may feel anxiety or depression, a common occurrence with vision loss. A mental health professional can help you explore therapy options that can help.

Ongoing research aims to increase treatment effectiveness for wet AMD. Areas of investigation include gene therapy to help your eyes make their own anti-VEGF medication.

Other promising ideas include an implantable port that slowly releases medication into the eye and injectable medications that last longer and require fewer injections.

Currently, there’s no cure for wet AMD, but treatments can help reduce the amount of vision loss you experience. There are also some lifestyle changes, medications, and surgical procedures you can try.

Without treatment, wet AMD causes rapid, progressive central vision loss. It’s important to seek early, sustained treatment to save as much of your vision as possible.

Wet Macular Degeneration Prognosis: Outlook and More (2024)

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